DESCRIPTION: (Applicant's Abstract) This is an application for a K02 Independent Scientist Award in response to PA-95-050. The award will permit the applicant to obtain additional training and education and to develop a funded R01 program in health services research for drug use disorders. The investigator's proposed research plan studies the relationship between health care utilization and patient outcomes in individuals with drug use disorders and comorbid medical (including HIV/AIDS) and psychiatric conditions. The research will be conducted largely within a rural context to provide critical information about this largely understudied population of drug users. The investigator is an experienced and funded health services researcher in alcohol use disorders. She proposes a natural progression from a single substance use disorder, alcohol, to the larger issues of services and outcomes for the range of drug use disorders. She has identified a number of methodological and substantive issues for which to obtain training during this five-year award and outlines specific educational programs and mentoring groups to assist in this effort. The specific aims of her proposed research plan are: 1. To develop a stronger scientific understanding of the unique aspects of drug use disorders, the unique scientific issues, and the broad array of health services proved to these individuals; 2. To understand how treatment services or other health services are provided to rural individuals with drug use disorders and to individuals with comorbidity including HIV/AIDS and the outcomes of these services; and 3. To develop a research knowledge of individuals with drug use disorders in medical settings, including emergency departments and primary care, particularly for rural residents and individuals with comorbid medical (including HIV/AIDS) or psychiatric conditions. To accomplish this research plan, the investigator proposes to conduct three projects: (1 ) Availability of Drug Treatment Services and Outcomes for Individuals with Drug Use Disorders and Comorbidity; (2) Detection, Management, and Health Care Outcomes for Individuals with Drug Use Disorders in Emergency Department Settings; and (3) Development of Conceptual and Theoretic Work about Comorbidity in Drug Use Disorders.